Relationship between Initial Quetiapine Dose and Effectiveness as Reflected in Subsequent Mental Health Service Use among Patients with Schizophrenia or Bipolar Disorder

Authors: Gianfrancesco, Frank; Wang, Ruey-hua¹; Pesa, Jacqueline²

Source: Value in Health, Volume 8, Number 4, July 2005 , pp. 471-478(8)

Buy & download fulltext article:

Price: $48.00 plus tax (Refund Policy)

Abstract:

Objective:

To investigate the association between initial quetiapine dose and effectiveness as gauged by subsequent use of mental health services. Methods:

Using a health plan database, we identified patients with bipolar disorder or schizophrenia treated with quetiapine monotherapy for at least four consecutive months. The stability of each patient before and after quetiapine treatment was measured by use of mental health services other than antipsychotic drug, measured primarily by charges reported on claims. Regression models controlling for patient differences measured associations between initial quetiapine dose and subsequent mental health service use. Results:

Commercially insured patients with schizophrenia (n = 581) or bipolar disorder (n = 2421) received quetiapine monotherapy at mean (SD) initial daily doses of 237 (198) mg and 147 (171) mg, respectively. Both groups showed negative associations between initial daily dose and subsequent mental health charges. Among patients with schizophrenia, mental health charges decreased by $1.28 for each additional milligram of quetiapine (P = 0.1097). Among patients with bipolar disorder, there was a significant decrease of $1.31 per additional milligram of quetiapine (P = 0.0484). For schizophrenia, hospitalizations were reduced by 0.4% for each additional milligram of quetiapine (P = 0.0189). For bipolar disorder, the association between quetiapine dose and outpatient charges was negative and trended toward significance (P = 0.074), showing a $0.54 reduction in these charges for each additional milligram of quetiapine; the association with hospitalization was not significant. Conclusions:

In patients with schizophrenia or bipolar disorder, higher initial doses of quetiapine may be more effective in stabilizing patients as reflected in lower subsequent mental health service use.

Keywords: bipolar disorder; dosing; quetiapine; resource use; schizophrenia

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1524-4733.2005.00038.x

Affiliations: 1: HECON Associates, Inc., Montgomery Village, MD, USA; 2: AstraZeneca Pharmaceuticals, Wilmington, DE, USA

Publication date: 2005-07-01

Relationship between Initial Quetiapine Dose and Effectiveness as Reflected in Subsequent Mental Health Service Use among Patients with Schizophrenia or Bipolar Disorder

Buy & download fulltext article:

Tools

Key

Text size:

Useful pages